Suffering from high cholesterol and heart palpitation. Worrisome

I have cholesterol level 6.4. My father has had a quadruple bypass and my brother died suddenly of a heart last year at 46. I'm 32. I had a heart palpitation last week. Heart feels likes it's 'dropping' a lot lately. Im female, have quit smoking 6 months ago. I eat fairly healthy take multi vitamins and exercise 5-6 times a week.

I presume the value of 6.4 is of total cholesterol – it is high. There are subdivisions – LDL, HDL, non-HDL and so on. LDL (& non-HDL) is bad – lower, the better. HDL is good – higher, the better.

It is generally the bad one, which is up! If it is – despite diet and exercise – you need drugs; statin is the first choice

Your family history is not a favourable one. Your age now and gender are favourable. Coronary Artery Disease (CAD) in women before menopause – is less common, but not unknown.

It is wise that you have quit smoking! Great motivation and achievement... Keep it up

Regular exercise and healthy eating are also good. Cholesterol can be high in spite of these. Diet contributes certainly. But it is also manufactured in the liver – and that is determined by heredity.

Your feeling of ‘dropping’ point to missed beats. Though they may be normal in many, it is advisable to investigate. A clinical examination and Electrocardiogram (ECG), followed by an ECHOcardiogram is the first step. 24 to 48 hour ambulatory monitoring (Holter) is done to analyse and plan for further management. Nowadays, there are advanced investigation and treatment modalities to manage them all. No cause for concern in general.

Your symptoms do not suggest CAD. However, it is better to have a Treadmill Exercise Electrocardiogram (TMT), to rule out. If it is normal, nothing to do – except to repeat annually. If in doubt, further work up is done – like thallium stress ECG, 124 slice CT angiogram, etc...

Sorry, it is rather long! In summary –You need to do Holter and TMTYou need cholesterol medicationYou need annual follow up